| NPI | 1548322365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY C FITTER Owner/Physician 985-384-7900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: LA L04053R) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2015-08-06 |